To examine the effects of chronic health conditions, as well as personal resources and regional context on labour force participation, receipt of government transfer payments and use of health services by short- and long-stay immigrants compared with native-born Canadians

Immigrants from South America had higher probability to be referred for any health problem, while Asiatic immigrants have the lowest overall probability of referrals
Immigrants from Western countries, Central America and the Caribbean showed similar referral rates to Spanish natives

To describe and compare the use and frequency of use of PHC services between immigrants and natives in Norway To investigate the importance of morbidity burden, socio-economic status and length of stay in Norway for immigrants’ use of PHC services

(1) Percentage of each population who had used the PHC system (GPs, EPC and both) in 2008 (2) Frequency of use among PHC users

Country of birth (1) Natives (born in Norway with both parents born in Norway) (2) Immigrants (born abroad with both parents from abroad) staying at least 6 months, divided according to the World Bank income categories of their country of origin

Significantly fewer immigrants from all but LIC used their GP and all PHC services, but a higher share of immigrants except those from HIC used the EPC. This higher use did not compensate for less use of GPs in terms of overall use of PHC
Among GP users, however, immigrants used the GP at a statistically significant higher rate compared with natives
Immigrants 65 years from all but HIC used GPs less than other age groups, and the same was true for overall use of PHC, although older immigrants from LIC used the EPC most The use of PHC services, but not the rate of use, increased with length of stay in Norway

To describe the utilization of PHC in Norway in terms of number of consultations, diagnoses given and procedures undertaken To compare native Norwegians’ use of PHC services with that of different immigrant groups

(1) Frequency of use of PHC system (GP, EPC) in 2008 (2) Diagnoses received at GP and EPC consultations

Country of birth (1) Natives (born in Norway with both parents born in Norway) (2) Immigrants (born abroad with both parents from abroad) staying at least 6 months, divided according to the World Bank income categories of their country of origin

Education level Marital status Income level Length of stay in Norway Place of residence Reason for migration Age at migration

A lower proportion of HIC immigrants used PHC, but utilization was increasingly similar in older age groups
The mean number of consultations to both the GP and the EPC, and the mean number of different diagnoses for PHC users were higher for 50 to 65 years old OIC immigrants, but this pattern was reversed for older adults

Immigrants were more or less likely to access primary mental health care depending on the world region of origin
Regarding specialty mental health care (psychiatry and hospital care), immigrants used it less. Across the 3 mental health services, estimates of use by immigrant region groups were among the lowest for newcomers from East Asian and Pacific and among the highest for persons from Middle East and North Africa

Immigrants in all admission classes and of both sexes were generally less likely to use all three types of mental health service. The exceptions were for primary mental health care, where male refugees were more likely to have at least one visit For PHC, estimates of intensity of use were highest for refugees and lowest for economic class immigrants For psychiatric care and hospital care, estimates were similar across admission class groups

Country of birth divided according to the World Bank Income categories (1) LIC (Ethiopia, Eritrea, Somalia, Democratic Republic of Congo, Zimbabwe, Gambia, and Pakistan) (2) MIC (Poland, Former Yugoslavia, Turkey, Iran, Iraq, Morocco, Philippines, and Thailand)

Age Causes of death

–

Suboptimal care was a significantly more frequent contributing factor of maternal death for the foreign-born women. Many of these deaths were associated with communication-related barriers and delays in care-seeking
Immigrant lower health coverage represents the first factor generating inequalities in the propensity to contact a GP, while education and income are the most important drivers of inequalities in the propensity to contact a specialist

13,959 individuals Born in France (n = 12,711) Born in North Africa (n = 327) ≥45 years

The objective of the present study was to determine DT2 prevalence and management in immigrants from North Africa living in France to ascertain whether the higher diabetes mortality observed in this population compared with the French-born population reflected a higher prevalence of DT2, poorer health status and or lower quality of care

(1)GP visits last year (2) ≥ 1 private specialist (ophthalmologist or endocrinologist) visit last year (3) Hospitalization >24 h last year 4) Length of stay of hospitalization

Country of birth
(1) Born in France (2) Born in North Africa

Age & gender Diabetes complications Smoking

Education level Financial difficulty

Reflects a greater prevalence of DT2, poorer health status and/or lower quality of care in this population
Our present study found no major differences between patient groups in terms of medical visits except for less frequent GP and more frequent dentist visits in the BNA population

To compare healthcare resource utilization (drug prescriptions, hospital admissions and healthcare services) in regular immigrants living in the Lombardy Region of Northern Italy at least 10 years versus native elderly people (65 years or older)

(1) Regular immigrant (born in a country other than Italy and registered with the Italian NHS) (2) Native (born in Lombardy)

Age & gender

–

Older immigrants (65 years and older) present under-utilization of healthcare resources and prescriptions drugs, including those from HIC European countries Only immigrants from Eastern Europe and Eastern Africa have a higher prevalence for hospital admissions. Only immigrants from Northern Africa have higher rate of prescriptions

In 2012 the immigrant population had a higher prevalence of visiting the GP compared to 2006
The immigrant population had a lower prevalence of visiting the specialist both in 2006 and 2012
The difference in use of ED decreased slightly for both groups and the difference between them was maintained from 2006 to 2012; the immigrant population showed a higher prevalence of use of this care level
No significant differences were found between both populations in terms of hospitalizations

(1) To describe the socio-demographic and socio-economic differences between migrants and non-migrants as broad groupings and by ethnicity, as well as within migrant groups by length of residence in the UK (2) To investigate the associations between migration status and health-related outcomes, including health behaviours, functional limitations, physical and mental health status and health service use (3) To examine whether and how the effect of migration status changes when it is disaggregated by length of residence, first language,reason for migration and combined with ethnicity

Survey-based study
South East London Community Health (SELCoH) survey

(1) Registration with GP (2) Visits to a GP for an emotional problem in the last 12 months (3) Seen a counsellor or mental health specialist in the last 12 months (4) Use of hospital services (accident and emergency and other outpatient department) in the last 12 months

(1) Migration status (2) Length of residence in the UK (3) First language (4) Reason for migration (5) Migration status within each ethnic group category

Migrants who had been in the UK for < 5 years, white migrants and those who migrated for education or work had increased odds of not being currently registered with a GP
Migrants who had been in the UK for 5–10 years had increased odds of seeing a GP for an emotional problem. Those who had resided in the UK for <5 years had decreased odds
Those who had migrated for education had increased odds of visiting an outpatient department compared to non-migrants decreased odds of seeing a GP for an emotional problem

Analyse all registered pharmacological treatments for immigrants from Poland, China, Morocco and Colombia compared to natives, aiming to identify patterns of drug use for each immigrant group compared to host countries

In the two countries studied, the proportion of immigrants that purchased drugs was significantly lower than that of the correspondingnative population
Immigrants from Morocco showed the highest drug purchase rates in relation to natives, especially for antidepressants, pain killers and drugs for peptic ulcer.
Immigrants from China and Poland showed lowest purchasing rates, while Colombians where more similar to host countries

(1) To analyse the use of primary care services by immigrants compared to Spanish nationals, adjusted by age and sex (2) To analyse the differences in frequency of visits to primary care in relation to geographic origin

To investigate ethnic differences as a factor in mental healthcare consumption in patients with medium & high risk of CMD (common mental disorders) and to identify determinants that may explain possible ethnic differences

Country of birth (subject and parents)
(1) Native Dutch (2) First-generation immigrant (foreign born and almost one parent foreign born) (2) Second-generation immigrant (born in Netherland with at least one parent foreign born)

Ethnic minority groups contacted the GP significantly more often than native Dutch people, with the exception of Antillean/Aruban immigrants
First-generation immigrants tended to contact the GP more often than second-generation immigrants
The four ethnic minority groups visited a mental healthcare specialist more often than the Dutch; this was significantly higher among the Turks

To study: (1) the prevalence of dysphoric disorders among different groups of migrants (first and second generation from different regions) in comparison to the native Austrian population using a validated questionnaire (2) The influence of gender, socio-economic factors, fluency of host language and length of stay in Austria on this prevalence (3) The utilization of healthcare services of migrants and Austrians with and without a dysphoric disorder

Survey-based study
(Telephone survey ad hoc and PHQ-4)

(1) Visits to a GP in the last 4 weeks (2) Visits to specialists in their own practices in the last 4 weeks (3) Out or inpatient hospital care in the last 4 weeks (4) Prevalence of dysphoric disorders

Country of birth and country of birth of fathers

Age & gender Chronic disease

Education level Employment status Living area Persons in house

No significant difference was found in the utilization of healthcare services associated with dysphoric disorders, except for a higher utilization of secondary/tertiary care by female migrants with a dysphoric disorder Immigrant males without dysphoric disorders had a lower utilization rate

Test the validity of the assertion that undocumented immigrants are more frequent users of health care

Survey-based study
California Health Interview Survey (CHIS)

(1) Number of doctor visits in the past year (2) Percentage of respondents with an ED visits among children and adults in the past year (3) Percentage of children who had a doctor visit in the past year

Foreign citizen (FC) (people without Spanish citizenship)
(1) FCs from high income countries (born in 25 European Union countries, Switzerland, Iceland, Norway, the USA, Canada, Japan, and Australia)
(2) FCs from low income countries (born elsewhere: North Africa and the Middle East, Latin America, Eastern Europe, Sub-Saharan Africa, and Asia)

Age & gender
Diagnosis at discharge
Unit of admission
Destination at discharge
Length of stay

Age & gender
Mental illness diagnosis
Age at first contact
Duration of episode

Education level
Marital status
Working status
Living arrangement
CMHC area

Although the probability of receiving any mental health intervention is similar between immigrants and Italians, the number of interventions and the duration of admissions are lower for immigrants
Immigrants spend less days of residential care in licensed psychiatric facilities or other facilities

To investigate whether potential differences exist in the use of private practicing psychiatrists and psychologists

Register and survey-based study
Survey and registry study on health and health behaviour of individuals registered at the Danish Civil Registration System (CPR number)

Use of psychiatrist or psychologist last year

Citizenship:
(1) Ethnic Danes (at least one parent born in Denmark with Danish citizenship) (2) Immigrant (people residing in Denmark for a minimum of 3 years and born in a foreign country to parents without Danish citizenship) (RGC: Refugee Generating Countries: Turkey, Pakistan, Iraq, Iran, Lebanon, Syria, Somalia and Yugoslavia)

Immigrants from RGC have similar or higher use of psychiatrists and psychologists in private practice when taking mental health into account Labour immigrants in general, except for women using psychiatrists, have lower use of psychiatrists and psychologists

(1) To identify in which forms of treatment immigrant women are over or under represented compared with native Norwegians, and if this varied by country of origin (2) To determine whether use of an interpreter increases the likelihood of accessing different treatment types

Country of birth
(1) Natives (born in Norway with both parents born in Norway) (2) Immigrants (born abroad with both parents from abroad) staying at least 6 months, divided according to the World Bank income categories of their country of origin

Age
Diagnosis
Use of interpreter

Marital status
Income level Length of stay Place of residence

Women are somewhat underrepresented in PHC services for mental health problems A higher percentage of Norwegian women had had a Psychiatric consultation than any of the 6 immigrant groups Psychiatric referral rates did not differ by country of origin

(1) Provide a detailed accounting of ED use with policy-relevant immigrant classifications (2) Examine associations between ED use and citizenship status using a Behavioural Model of healthcare access and utilization (3) Determine the most important factors associated with differences in immigrants’ ED services use

(1) Unmet healthcare need in the last 12 months (2) Visit to a GP in the last year (3) Visit to dentist in the last year (4) Hospitalization and ED visit in the past year (5) Drug consumption it last 2 weeks

(1) To analyse differences in patterns of healthcare use (visits to PC, hospitalizations and emergency visits) between the native Spanish population and immigrants from the seven leading countries in terms of number of immigrants in Spain in 2006 (2) To examine whether the differences are explained by self-perceived health status, educational level, family characteristics, employment status and social support (3) To determine whether the patterns of association differ by gender

Survey-based study
Spanish National Health Survey (SNHS) 2006–2007

(1) Visit to a GP in the 4 weeks before (2) Hospitalization in the past year (3) ED visits in the past year

Country of birth

Age & gender
Self-perceived health status

Marital status
Educational level
Employment status
Social support (adapted from the Duke-UNC Functional Social Support Questionnaire)
Social support (adapted from the Duke-UNC Functional Social Support Questionnaire)

Immigrants made less than, or about the same use of healthcare services Among men, a lower use of healthcare services was found among those born in Romania for all healthcare levels and among Ecuadorians for hospitalizations
Among women a lower use of PHC was found among those born in Argentina, Bolivia and Ecuador, and a higher use among Peruvians. No differences were observed with native-born subjects A higher utilization of healthcare services was only found among men born in Bolivia, who were more likely to use hospitalization

Of the three groups, Koreans use health services the least
They have the lowest rate of having a regular doctor and overnight stay in hospital, the lowest numbers for dental and physician visits in the past 12 months, and the highest rate of no doctor visit in the past 12 months